Organization
THE TEST WAREHOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN M COHEN (CEO)
(641) 919-8347
Entity
Organization
Contact information
Practice address
102 S 6TH ST, FAIRFIELD, IA 52556-3334
(641) 919-8347
Mailing address
54 1/2 N MAIN ST, FAIRFIELD, IA 52556-3205
(641) 919-8347
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16D2211249
CDC
—
Enumeration date
01/09/2021
Last updated
01/28/2022
About Stedi
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